Last Public Health Visit!!

Yesterday was my last public health visit!!!!

There were no balloons or streamers.  The receptionist did not light up and say "Congratulations on making it though!"  In fact, I had to remind her that this was my last visit and find out if I had to come back in.  Yes, I have to return to get my CERTIFICATE!!!  Who would have thought that I'd get a certificate out of this.

My actual meeting with my dear little nurse took about 6.25 minutes including her story about two Buddhist nuns who came to visit with her. She had my bottle of INH ready to go and already labeled...shocking.  Blood pressure: 105/79, check.  Weight, check.  Buddhist nun story, check.

"So this is my last visit," I said, trying to lead her into an exclamatory "You did it!  Let's go have a beer!"
"Yes!" was all I could pull out of her.  But she's so cute, and they way she modulated her voice was more like "Yaaaaaeeess!"
"Will I need to come back in after I finish my bottle?" I jutted out the blue-capped bottle in my hand.
"Oh...you'll need to come back in after you finish and I will need to make out your certificate." She nodded and smiled.
"What is the certificate for?  Just to say I finished all of my INH pills" and to myself I completed "for nine long months, like a good little girl."
"Yes and you'll need to sign something saying you won't take another test.  And if you have any problems in the future you can just come back to me."  Ick, I though...like if I visit a foreign country and contract TB?  What are my chances...?
"What happens with the test?  Will I contract TB if I take one?"  Terror beginning to rise...
"Oh, no.  But you will always be positive on it."

Hmmm.... The legacy of my TB is not behind me.  Every time I go to the doctor and encounter "the test" I will need to explain my nine-month gestation with latent TB.  Lovely.  But at least I'll have my certificate!

I'll have to look up more info.  I'm already setting up acupuncture appointments to help strengthen my liver, post INH.  More on that to come.

Congratulations to me!!!

How Low Can You Go: Blood Pressure and INH

During my months in blogging darkness, I had (maybe still having) some bouts with low blood pressure.  Supposedly this isn't anything to worry about since my dear nurse didn't have any adverse reaction.  My normal BP is about 105/65.  Not bad, particularly when I'm not exercising and all that stuff.

As I mentioned in my last post, two Public Health visits ago I went in and my initial BP read 80/55.  She shifted it to the other arm and it came in at about 95/60.  So that's great, right?  Probably...However I, with my paranoid mind, have made a few ties to a couple of things.

1. The night before I went in to Public Health I felt dizzy and weak.  I don't watch much TV, and have only a single show that I try to watch.  Fell asleep in the middle of it.  Complained that I felt like my body just needed water and lots of it.

2. The day, after having my blood pressure measured I continued to be weak and almost fainted twice. I continued with the same symptoms.

Coincidence?  In my heart of hearts, I don't believe so.  Even though her final measurement was fine, I've NEVER had to have my BP taken more than once. And 95 is still low for me.

Let me list some signs and symptoms of low blood pressure:

• Dizziness or lightheadedness
• Fainting (syncope)
• Lack of concentration
• Blurred vision
• Nausea
• Cold, clammy, pale skin
• Rapid, shallow breathing
• Fatigue
• Depression
• Thirst

Dizzy - check, Fainting (or almost) - check, Lack of concentration - check, Fatigue - check, Thirst - check.
Hmmm...

So let's say (hypothetically) that my blood pressure was low.  That I was suffering from hypotension.  What's the cause, is it normal, is it INH and most importantly, what kicks it back to normal?  Well, if I'd been keeping track of my food, my diet and other things like I'd started out doing, I'd probably be able to better answer this as it applies to me.  But alas, I have to go from memory, which was practically wiped clean because of my hypothetical hypotension bout.  Or at least, I can blame it on that.

I'll be pondering this more...lots more research to do...

To Vitamin or Not To Vitamin

My last visit to my dear, sweet nurse at public health went pretty much the same as usual.  I go in, we talk about her arthritis, her grandchild, my boy, she takes my blood pressure and then she gets me my bottle. Really...there's no serious questionnaire to be completed, no probing discussions.  Last month, I'd been feeling rather "odd" and she didn't really flinch when my blood pressure was 80/55.  "Let's try the other arm then."  It came back 95/60.  

I figured she must have supreme confidence in my conversational skills and my ability to plop down on the table anything that might be wrong with me.  Let's try not to think "diseased liver" or anything...keep it light.  So I said, "I've been grumpy, tired and arthritic STILL."  She put me right in my place..."So the B6 isn't working anymore?"

Ah, well, I stopped taking the B6 back in May.  In fact, I stopped doing ANYTHING good in May.  Even Vitamins went out the window, although I still got my dose of Vitamin Sun (D).  Hmmm...

Now my multivitamin is a beast - Six horse-pill sized vitamins are the daily dose.  Food-based and absolutely chock full of everything good, including plenty of B6.  I love 'em, swear by 'em, but haven't been taking them.  Aside from my own psychological problems that are keeping me from good health (yes, I know I have my fair share and lately the grab bag has been quite full) there are some basic physical tenets that I recognized when I started this blog:

1. Eat well and logically
2. Avoid histamine rich and inducing foods
3. Supplement

So when I say that I feel like crap but I'm not doing any of the above, who do I have to blame?  Yep, numero uno right here typing this in.  I hate these kinds of epiphanies.

This morning, I took three multi-vitamins.  At lunch I'll take another three.  I want to continue this through the week.  I have a sneaking suspicion that my energy levels will increase and my general well being will too.

Why do I always have to learn the hard way?

Month 1, Day 30

Eureka!  INH can actually induce arthritis!

But wait, let me back up...Last week I went to Public Health for my second visit and an INH refill.  My sweet nurse asked me a few questions, weighed me (I've happily lost 3 pounds) and then got me another bottle of INH.  When I told her that I think INH has caused me to have arthritis she was surprised.  "Really?  And you've never had it before?  Who told you that you had arthritis?"

Well, truth be told, I've self-diagnosed.  In the past, the only times I've felt these arthritic-like symptoms was when I drink wine or beer.  The next morning my hands and joints ache and are incredibly weak.  About my third week in to INH, my hands started aching in EXACTLY THE SAME WAY.  But it didn't go away as the day progressed...my hands just ache all the time.

So I explained this to my sweet babushka nurse and she wanted to try B6 even though I get 1000% B6 in my multivitamin.  She teetered out and brought back a B6 that gave me 2000% in one pill.  "Try this without taking your multivitamin for a week and see if it helps.  If not, go ahead and start the multivitamin again."

It hasn't helped...not one bit. So I'm taking my multi again slightly early.  It hasn't been quite a week.  Only 5 days.  My hands feel exactly the same.

The good news it that I've made some connections:
1. INH can, in fact, induce arthritis.  There are studies in which it induced acute arthritis, and when the patient when off, the symptoms disappeared.  When started again, the symptoms reappeared. (Source 1), (Source 2)
2. Since my symptoms pre-INH usually appeared after wine/beer, two high-histamine liquids, and since INH inhibits histamine metabolism, it may be that my histamine intake is exceeding my metabolism of histamine, and adding to the arthritic feeling in my hands. In fact, histamine has been associated with arthritis - causing the joints to become "leaky" allowing the arthritic process to start. (Source)

So from here - I'm going to try an experiment. Remove all (or as many as possible - nearly impossible to remove every bit of histamine - See the Histamine Page for more info) histamine foods from my diet.  This really sucks because I really like a lot of them:
* Certain vegetables: tomato, spinach, eggplant, avocado, mushrooms and canned vegetables as well as commercially prepared salads
* Certain fruits: strawberries, bananas, papayas, kiwi, pineapple, mango, tangerines, grapefruits, red prunes, pea
* Red wine vinegar, balsamic vinegar
* Soy sauce
* Sunflower seeds
* Chocolate/cocoa
* Coffee, black tea
* Some fruits: citrus, bananas, strawberries, red prunes, pears, kiwi, raspberries, papaya
* Peanuts, cashews, walnuts

Yep - I'm going to be hurtin' because I have tomatoes and avocados practically every day.  I eat bananas and cocoa all the time.  I love balsamic vinegar.  I include strawberries, kiwi and oranges in my diet frequently. I drink black tea in the form of chai daily.

This sucks - but it sucks worse to have my hands hurt.  It's worth a try for a few weeks to see what happens.
I'll keep you posted.

Month 1 - Day 1

The Public Health Department nurse who interviewed me after my PPD and chest Xray suggested that I take my INH pill after dinner to lighten nausea. I think that's a great idea, so my first day, possibly week, will just be about remembering to take my pill.

The Public Health department in Santa Fe, New Mexico was very easy to work with on my initial visit. After looking at my paperwork, the sweet, elderly hispanic nurse asked me a few questions that she'll ask every month as I return for my next 30-day dose. These questions help them identify what symptoms I have, and if I might be reacting adversly to INH. To me, if I vomit, that will be an adverse reaction, but the next medication in line might be even worse.

Since INH is hard on the liver (thus the increased risk of hepatits and requirement of little alcohol and increased problems with blood sugar) my desire through this 9 months is to provide adequate liver support. I hope to try different things that I wouldn't normally try. Although my diet is usually pretty good, I believe this 9 months will push me above and beyond my normal diet and force me to be as clean as possible. Imagine that...

My Diet Today:
Breakfast: Ezekial Toast with Avocado, Tomato and spike
Snack: Big bag of carrots and Hummus
Lunch: Cooked veges with goddess dressing on top
Snack: Grapefruit and nuts
Dinner: Kale and a Millet pilaf

My diet is pretty healthy for the most part anyhow, so this isn't a huge change for me. I could understand how this would really suck for a lot of people who drink soda, eat a lot of chips and refined products, etc. I'm pretty lucky on this end.

The First Pill
This morning I set out the bottle. It still has the little flap of info attached to the lid. I lifted it up and felt a little like Socrates holding his hemlock. Tonight, at 8'clock on the nose less that 10 minutes after dinner, I popped the pill in while my partner was singing to me. At 9:00 PM, I feel my normal tired.

We'll see how I feel tomorrow...bedtime at 10 tonight.